Document Detail


Efficacy of an olmesartan medoxomil-based treatment algorithm in patients with hypertension and type 2 diabetes: analysis of diurnal blood pressure control as assessed by 24-hour ambulatory blood pressure monitoring.
MedLine Citation:
PMID:  20801941     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Secondary, prespecified analysis of a single-arm, open-label study evaluating the efficacy of olmesartan medoxomil (OM) plus hydrochlorothiazide (HCTZ) in patients with hypertension and type 2 diabetes.
METHODS: After placebo run-in, 192 patients received OM 20 mg/day for 3 weeks. If blood pressure (BP) remained ≥120/70 mmHg, patients were uptitrated every 3 weeks to OM 40 mg/day, OM/HCTZ 40/12.5 mg/day, and OM/HCTZ 40/25 mg/day. Efficacy was evaluated by 24-hour ambulatory BP monitoring. Secondary endpoints included changes in ambulatory systolic BP (SBP) and diastolic BP (DBP) during daytime (08:00 to 16:00) and nighttime (22:00 to 06:00), as well as achievement of prespecified ambulatory BP targets in the total cohort and subgroups based on gender, race, hypertension severity, and age (≥65 or <65 years). Dipper status (nocturnal decrease in BP ≥10% of mean daytime BP) was assessed.
RESULTS: At baseline, mean ambulatory BP was 151.2 ± 12.7/87.6 ± 9.0 mmHg during the daytime and 140.3 ± 13.1/78.1 ± 8.6 mmHg during the nighttime. Mean daytime and nighttime ambulatory BP was reduced from baseline by 22.3 ± 13.7/12.0 ± 8.9 mmHg and 18.8 ± 12.4/ 10.2 ± 7.2 mmHg, respectively. The reduction in daytime ambulatory SBP was 24.4 ± 11.8 mmHg in Blacks, 21.7 ± 14.2 mmHg in non-Blacks, 23.6 ± 12.3 mmHg in females, 21.2 ± 14.8 mmHg in males, 23.4 ± 11.6 mmHg in patients aged ≥65 years, and 21.9 ± 14.4 mmHg in those aged <65 years. Ambulatory BP targets of <130/80, <125/75, and <120/80 mmHg were reached by 51.7%, 36.0%, and 32.6% of patients during the daytime and 69.8%, 60.5%, and 50.6% of patients during the nighttime. After 12 weeks of treatment, 36.4% of baseline nondippers converted to dippers.
CONCLUSIONS: OM ± HCTZ effectively lowered ambulatory BP in patients with type 2 diabetes and hypertension, enabling them to achieve ambulatory BP targets during both the daytime and nighttime.
Authors:
Dean J Kereiakes; Joel Neutel
Publication Detail:
Type:  Controlled Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2010-08-27
Journal Detail:
Title:  Therapeutic advances in cardiovascular disease     Volume:  4     ISSN:  1753-9455     ISO Abbreviation:  Ther Adv Cardiovasc Dis     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-05     Completed Date:  2011-01-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101316343     Medline TA:  Ther Adv Cardiovasc Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  285-93     Citation Subset:  IM    
Affiliation:
The Carl and Edyth Lindner Center for Research and Education at The Christ Hospital, 2123 Auburn Avenue, Suite 424, Cincinnati, OH 45219, USA. lindner@thechristhospital.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Algorithms
Antihypertensive Agents / administration & dosage*,  adverse effects
Blood Pressure / drug effects,  physiology
Blood Pressure Monitoring, Ambulatory*
Circadian Rhythm / physiology
Diabetes Mellitus, Type 2 / complications*
Drug Therapy, Combination
Female
Humans
Hydrochlorothiazide / administration & dosage,  adverse effects
Hypertension* / complications,  diagnosis,  drug therapy
Imidazoles / administration & dosage*,  adverse effects
Male
Middle Aged
Placebos
Prospective Studies
Tetrazoles / administration & dosage*,  adverse effects
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 0/Imidazoles; 0/Placebos; 0/Tetrazoles; 144689-24-7/olmesartan medoxomil; 58-93-5/Hydrochlorothiazide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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